Background: The main goal of this post hoc analysis of the Collaboration to Collect Autologous Transplant Outcomes in Lymphoma and Myeloma (CALM) study was to evaluate the rate of short- and long-term infectious and non-infectious complications occurring after ASCT in patients with multiple myeloma (MM). Methods: The analysis included all patients with MM from the CALM study who underwent ≥1 ASCT. The primary endpoint of the analysis was to determine the rate of infectious and non-infectious complications after ASCT and to compare them in three time periods: 0−100 days, 101 days−1 year, and >1 year after the first transplant. Results: The analysis included a total of 3552 patients followed up for a median of 56.7 months (range 0.4−108.1). Complication rates decreased with the time from ASCT with 24.85 cases per 100 patient-years from day 0 to 100 days after the transplant, and <2.31 cases per 100 patient-years from the 101st day. At 100 days after ASC T, 45.7% of patients had complications, with infectious events being twice as frequent as non-infectious complications. Bacterial infections (6.5 cases per 100 patient-years, 95% CI: 6.1−7.0) and gastrointestinal complications (4.7 cases per 100 patient-years, 95% CI: 4.3−5.1) were the most common early events. The pattern of complications changed with time from ASCT. The presence of complications after ASCT was not associated with overall survival. Conclusions: Our data provide a solid basis for comparing ASCT-related complications to those caused by emerging treatments in multiple myeloma, such as CAR T-cell therapy and other immunotherapies.

Belfast City Hospital Belfast BT9 7AB UK

Centre de Recherche Saint Antoine Sorbonne Université INSERM UMR_S 938 75013 Paris France

Charité Universitätsmedizin Berlin 10771 Berlin Germany

CHU de Lille 59000 Lille France

CHU Nantes 44000 Nantes France

Clinical Research Institute Helsinki University Hospital and University of Helsinki 00280 Helsinki Finland

Comprehensive Cancer Center Department of Hematology Helsinki University Hospital and University of Helsinki 00290 Helsinki Finland

Dél Pesti Centrumkórház 1097 Budapest Hungary

Département d'Hématologie et de Thérapie Cellulaire Assistance Publique Hôpitaux de Paris Hôpital Pitié Salpetrière 75012 Paris France

Department of Cellular Therapy and Allogeneic Stem Cell Transplantation Karolinska Comprehensive Cancer Center Karolinska University Hospital Huddinge 17177 Stockholm Sweden

Department of Haemato Oncology St Bartholomew's Hospital Barts Health NHS Trust London EC1A 7BE UK

Department of Hematology Hemostasis Oncology and Stem Cell Transplantation Hannover Medical School 30625 Hannover Germany

Department of Hematology Transplantation and Internal Medicine University Clinical Centre The Medical University of Warsaw 02 097 Warsaw Poland

Department of Hematology University Hospitals Leuven 3000 Leuven Belgium

Department of Internal Medicine 5 Division of Hematology Oncology Heidelberg University Hospital 69120 Heidelberg Germany

Department of Internal Medicine School of Medicine University of Zagreb 10000 Zagreb Croatia

Department of Medicine University of Eastern Finland and Hospital District of North Carelia Kuopio University Hospital 70211 Kuopio Finland

Department of Pediatric Hematology and Oncology Collegium Medicum UMK 85 067 Bydgoszcz Poland

Department of Public Health and Primary Care ACCENT VV KU Leuven University of Leuven 3000 Leuven Belgium

Division of Hematology Department of Medicine Huddinge Karolinska Institute 171 77 Stockholm Sweden

Division of Hematology SST Papa Giovanni XXIII 24127 Bergamo Italy

Division of Infectious Diseases Department of Health Sciences University of Genoa 16121 Genoa Italy

Division of Infectious Diseases IRC CS Ospedale Policlinico San Martino 16132 Genoa Italy

EBMT Data Office Leiden 2333 AA Leiden The Netherlands

George Papanicolaou General Hospital 57010 Thessaloniki Greece

Heinrich Heine Universitaet 40225 Duesseldorf Germany

Hope Directorate D08 NHY1 Dublin Ireland

Hôpital St Louis 75010 Paris France

Hospital Santa Creu i Sant Pau 08001 Barcelona Spain

Hospital Universitario Puerta de Hierro Majadahonda Universidad Autónoma de Madrid 28222 Madrid Spain

Imperial College London SW7 2BX UK

Institut Paoli Calmettes 13009 Marseille France

Nottingham University Nottingham NG7 2QL UK

R M Gorbacheva Memorial Institute of Hematology Oncology and Transplantation Pavlov University 197022 Saint Petersburg Russia

Radboud University Medical Centre Department of Hematology 6525 GA Nijmegen The Netherlands

Section of Adult Haematolgy BMT King Faisal Specialist Hospital and Research Centre Oncology Riyadh 11564 Saudi Arabia

Skanes University Hospital 23262 Lund Sweden

Tor Vergata University 00133 Rome Italy

University Hospital 12808 Prague Czech Republic

University Hospital Brno 62500 Brno Czech Republic

University Hospital Eppendorf 20246 Hamburg Germany

University of Cologne 50923 Cologne Germany

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